Purpose of review: Anatomical segmentation has played a major role within clinical cardiology. Novel techniques through artificial intelligence-based computer vision have revolutionized this process through both automation and novel applications. This review discusses the history and clinical context of cardiac segmentation to provide a framework for a survey of recent manuscripts in artificial intelligence and cardiac segmentation. We aim to clarify for the reader the clinical question of "Why do we segment?" in order to understand the question of "Where is current research and where should be?".
Recent findings: There has been increasing research in cardiac segmentation in recent years. Segmentation models are most frequently based on a U-Net structure. Multiple innovations have been added in terms of pre-processing or connection to analysis pipelines. Cardiac MRI is the most frequently segmented modality, which is due in part to the presence of publically-available, moderately sized, computer vision competition datasets. Further progress in data availability, model explanation, and clinical integration are being pursued.
Summary: The task of cardiac anatomical segmentation has experienced massive strides forward within the past five years due to convolutional neural networks. These advances provide a basis for streamlining image analysis, and a foundation for further analysis both by computer and human systems. While technical advances are clear, clinical benefit remains nascent. Novel approaches may improve measurement precision by decreasing inter-reader variability and appear to also have the potential for larger-reaching effects in the future within integrated analysis pipelines.
Keywords: Cardiac segmentation; artificial intelligence; cardiac MRI; cardiac imaging; computer vision; convolutional neural networks.